Is severity a clinically meaningful specifier of somatic symptom disorder?
Journal
Journal of Psychosomatic Research
Journal Volume
133
Journal Volume
133
Pages
110108
Start Page
110108
ISSN
0022-3999
Date Issued
2020-06
Author(s)
Abstract
Objective: Few existing studies have investigated the clinical relevance of Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) somatic symptom disorder (SSD) severity rated by clinicians. We examined the association of SSD severity with psychiatric and medical comorbidity, psychological features and help-seeking attitude and behaviours. Methods: A total of 123 patients with SSD were prospectively recruited and completed several types of self-report instrument. Information about medical comorbidity and healthcare use was gathered from the participants and medical record review. Common comorbid psychiatric diagnoses of SSD were assessed by psychiatrists. Group differences of patients with SSD of varying severity were assessed with ANOVA and chi-square tests. Multiple linear regression models were used to examine the relationships between SSD severity and psychological features. Results: Prevalence of medical comorbidity and comorbid psychiatric diagnoses of SSD was not significantly different among patients with varying SSD severity. Patients with severe SSD had the highest Patient Health Questionnaire-15 (PHQ-15), Health Anxiety Questionnaire (HAQ), Beck Depression Inventory-II (BDI-II) and Beck Anxiety Inventory (BAI) scores. Help-seeking behaviour was not associated with SSD severity. After controlling for demographic variables, the associations between ‘severe SSD’ and the PHQ-15, HAQ, BDI-II and BAI scores were significant. Conclusion: SSD severity rated by clinicians was not associated with comorbid medical or psychiatric diagnoses. Compared to patients with mild/moderate SSD, patients with severe SSD not only had higher somatic distress and health anxiety but also higher levels of anxiety/depression. However, SSD severity was not associated with help-seeking attitude and behaviour. ? 2020 Elsevier Inc.
Subjects
Comorbidity; DSM-5 specifier; Help-seeking behaviour; Severity; Somatic symptom disorder
SDGs
Other Subjects
adult; analysis of variance; anxiety disorder; Article; Beck Anxiety Inventory; Beck Depression Inventory; chi square test; clinical feature; comorbidity; depression; disease severity assessment; distress syndrome; DSM-5; female; health care utilization; help seeking behavior; human; major clinical study; male; multiple linear regression analysis; Patient Health Questionnaire 15; prevalence; prospective study; psychiatric diagnosis; psychiatrist; psychosomatic disorder; self report; symptom assessment; anxiety; Diagnostic and Statistical Manual of Mental Disorders; medically unexplained symptom; middle aged; psychology; questionnaire; Adult; Anxiety; Comorbidity; Depression; Diagnostic and Statistical Manual of Mental Disorders; Female; Humans; Male; Medically Unexplained Symptoms; Middle Aged; Prevalence; Self Report; Surveys and Questionnaires
Publisher
Elsevier Inc.
Type
journal article